When weekend activity becomes a real pain in the back

Most Monday mornings we get a call from someone in his 40s or 50s who threw out his back. Either he was competing in an obstacle course with old college buddies, or a 5K with younger co-workers. Or maybe, he injured himself doing a mud run with his kids.

Whatever it was that sounded like a good time on a Saturday, it sounds like back injury by Monday – and that’s when the “weekend warrior” calls my office requesting an urgent appointment.
Luckily, about 98 percent of the time little more is needed than rest. Pulling your back or shoulder is like spraining an ankle. With rest, it goes away.

I sympathize with the relatively sedentary person who suddenly decides to paint the house one weekend – and ends up missing work all week afterward. Back pain can be alarming and debilitating. And it may be difficult to know whether you’ve done permanent damage.

If you’re trying to assess whether you need to see a specialist, wait a few days to determine if the pain is starting to subside. If it isn’t, it might be a good idea to call your doctor. Similarly, if you’re experiencing sciatic-type pain, numbness or tingling down the leg, it may be worth getting checked out.

Usually, overdoing it on the weekend does little more than remind you that you’re getting older. Very rarely is an injury bad enough to require a trip to the emergency room. If you feel both legs go numb or have a bladder accident, that’s usually alarming enough that it can’t wait until Monday morning.
Also, if you experience a “foot drop,” where your leg is so weak that you either can’t pick up your foot or flex your toes, that signals that you may have a large herniated disc that should be seen immediately.

But for most of us, the worst we will experience are bad muscle spasms, where your whole back seizes up and leaves you crawling on the floor. It sounds bad (and feels worse), but the reason your muscles are seizing up is actually to help you.

What’s happening is the spine is slipping, so the muscles tighten to try to brace you and stop you from further injuring your spine.

The majority of the time, you don’t need surgery, you don’t need to go to the hospital and, unless the pain isn’t getting better or you have a history of back problems, you probably don’t need an assessment by me.

What you do need to do is prevent these problems from happening in the first place. Having a good fitness plan that builds up your stamina and strength over time is much better for you than plunging into an aggressive activity once every blue moon.

And don’t forget to stretch. Even if you’re just cleaning the rain gutters or moving furniture, strenuous physical activity could lead to muscle injury. Stretch your arms and shoulders, take breaks. Don’t do it all in one standing.

Also, before you throw the ball around with your kids, stretch with them. It gets your body loosened up and teaches your kids good workout habits, too.

It is important to keep in mind that everyone may have special circumstances or medical history that changes the situation. If you have any questions or concerns always contact your primary care physician for guidance and recommendations; it’s always better to be safe than sorry.

To all the weekend warriors out there, remember: I always encourage physical activity and exercise; as long as it’s done safely, come Monday, you won’t need my number.
– Dr. Burak Ozgur is a neurosurgeon and chief of service for the Neurosurgical Spine Program at Hoag.